CHARacterizing Pediatric Integrative Medicine Within a Large Academic Medical Center (CHARM)

Pediatric patients with chronic illnesses face a multitude of health challenges that are often inadequately addressed by conventional, siloed medical systems. Pediatric integrative medicine (PIM), blending complementary therapies with conventional medicine, offers an interdisciplinary and comprehensive approach to addressing these complex challenges. Despite growing demand for PIM, lifestyle-oriented care, and multimodal biopsychosocial interventions, few studies have described the clinical delivery of PIM within a large academic medical center.

To describe the demographics, clinical characteristics, and interventions utilized within a physician-led, PIM clinic at a large, pediatric academic medical center.

A retrospective review was conducted of 2677 outpatient PIM physician office visits (March 2020-September 2023) among 657 pediatric patients (birth-25 years). Data on demographics, diagnoses, interventions, and supplements were extracted from the electronic health record and summarized using descriptive statistics.

Patients (mean age 12.24 ± 5.20 years) were predominantly female (56%) and White (68%). Common conditions included anxiety (59.2%), fatigue (44.4%), headache (43.1%), abdominal pain (33.6%), constipation (33.0%), nausea (31.7%), vitamin D deficiency (30.1%), myofascial pain (29.5%), and depression (26.8%). Key intervention recommendations included dietary changes (61.8%), myofascial self-care interventions (33.8%), massage therapy (21.0%), acupuncture (19.2%), pacing (18.4%), sleep hygiene (18.3%), and exercise (18.1%). Common supplements recommended included probiotics (49.9%), vitamin D (42.6%), multivitamins (41.9%), fish oil (39.4%), magnesium (32.0%), Chinese herbs (29.7%), and melatonin (22.8%).

PIM can provide whole-person, integrative care within a large academic medical center for pediatric populations with complex presentations. Its self-governed structure within an academic medical center facilitates broad service integration, addressing demands for comprehensive care. Future practice-based research with standardized documentation and outcome measures is needed to understand PIM's clinical effectiveness.